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As rivers warm, cold‐water fish species may alleviate thermal stress by moving into localized thermal refuges such as cold‐water plumes created by cool tributary inflows. We quantified use of two tributary confluence plumes by juvenile steelhead, Oncorhynchus mykiss, throughout the summer, including how trout positioned themselves in relation to temperature within confluence plumes. At two confluences, Cedar and Elder creeks, along the South Fork Eel River, California, USA, we monitored temperatures using in situ logger grids throughout summer 2016. Fish were counted within confluences via snorkel surveys five times a day on 5 days at each site. We found diel and seasonal dependence on confluence use by steelhead, especially at the Cedar Creek confluence, where mainstem temperatures exceeded 28°C. At this site, fish moved into the confluence on the warmest days and warmest times of the day. Fish observed within the Cedar Creek confluence plume were most common in locations between 20–22°C, rather than the coldest locations (14.5°C). At Elder Creek, where mainstem temperatures remained below 24°C, there was little relationship between mainstem temperature and steelhead presence in the confluence plume. At both sites, steelhead distribution within plumes was influenced by spatial variation of temperature and mean temperature in surveyed grid cells. Our results show that cool tributaries flowing into warmer mainstem reaches (over 24°C) likely create important thermal refuges for juvenile steelhead. As mainstem rivers warm with climate change, cool‐water tributary inputs may become more important for sustaining cold‐water salmonids near the southern end of their range. [ABSTRACT FROM AUTHOR]

Parrott recently published a review of literature on MDMA/ecstasy. This commentary is a response to the content and tenor of his review, which mischaracterizes the literature through misstatement and omission of contrary findings, and fails to address the central controversies in the literature. The review makes several erroneous statements concerning MDMA-assisted psychotherapy, such as incorrect statements about research design and other statements that are baseless or contradicted by the literature. Though it critiques an attempt by other authors to characterize the risks of MDMA, the review fails to produce a competing model of risk assessment, and does not discuss potential benefits. Parrott does not represent an even-handed review of the literature, but instead recites dated misconceptions about neurotoxicity concerns involving the recreational drug ecstasy, which do not relate directly to the use of pure MDMA in a therapeutic setting. Unchallenged, Parrott's report may deter researchers from further investigating an innovative treatment that in early clinical trials has demonstrated lasting benefits for people with chronic, treatment-resistant post-traumatic stress disorder. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective In Uganda, formal and informal private practitioners (PPs) provide most case management for childhood illness. This paper describes the impact of negotiation sessions, an intervention to improve the quality of PPs’ case management of childhood diarrhoea, acute respiratory infection and malaria in a rural district in Uganda. Method Negotiation sessions targeted PPs working at private clinics and drug shops. The aim was to improve key practices extracted from the national Integrated Management of Childhood Illness Guidelines, and to measure the PPs’ performance before and after the intervention. Results Post-intervention the quality of case management for childhood diarrhoea, acute respiratory infection and malaria was generally better, although certain practices appeared resistant to change. We discovered various types of PPs who were mostly unregistered by the district authorities. Conclusions Results suggest the importance of maintaining ongoing monitoring and support to PPs to understand barriers to change and to encourage more practice improvement. Modifications to the intervention are needed to take it to scale and render it more sustainable. Getting local organizations and professional associations more involved could make it easier to establish and maintain contact with PPs. The government needs to simplify registration procedures and reduce associated fees to encourage PPs to register and thus be included in a large-scale intervention. Future interventions need to measure the impact on improving childhood case management at the community/household level. [ABSTRACT FROM AUTHOR]

Thermal microrefugia, sites within a landscape which are relatively protected from temperature extremes and warming trends, may be necessary for the conservation of animal species as climates warm. In freshwater environments, cold water fish species such as Pacific salmonids already rely on thermal microrefugia to persist in the southern extent of their range. Identifying sites that can provide such thermal microrefugia is essential to inform conservation and management decisions. At present, however, there is no consensus on appropriate ways to identify such sites, and multiple approaches are presented in the literature. Here, we use high resolution thermal data from two cold‐water zones created at the confluence of tributaries with a warm main channel of the South Fork Eel River in Northern California to demonstrate that the characteristics of cold zones identified as thermal microrefugia are not robust to the choice of microrefugium definition. Common definitions disagree on the existence, volume, seasonal temporal trends, and diurnal variations in microrefugia at the two confluences. The disagreements arise from the complex interaction between the confluence mixing regime with diurnal/seasonal warming patterns and how this shapes the distribution of water temperature at the confluences, and how it is classified by each definition. The disagreements cannot be resolved by simple bias correction approaches. Given that all existing definitions rely on simplifications that negate the nuanced way fish use cold water zones and respond to thermal stress, alternative observation and classification approaches may be needed to characterize cold zones in rivers as thermal microrefugia. [ABSTRACT FROM AUTHOR]